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Primary Health Networks: key questions and challenges

While the media has been focussed on the Government’s proposed GP co-payment, there have been potentially bigger changes to primary health care progressing behind the scenes. The transition from Medicare Locals to Primary Health Networks (PHNs) may not appear significant, as the functions and objectives of both organisations are very similar. However, there are some [...]


Celebrating some success in Tackling Indigenous Smoking

 Dr Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, responds to new smoking research with an update on the promising progress being made to tackle Aboriginal and Torres Strait Islander tobacco use and a reminder that more needs to be done if e are to close the health gap between Indigenous and non-Indigenous Australians.  He writes: 

New findings published this week in the international journal BMC Medicine indicate that up to 1.8 million of our 2.7 million smokers in Australia will die from their habit if they continue to smoke. This is a stark reminder of the benefits of quitting, or not taking up smoking at all.

The research provides an important reminder that while we have had some significant wins in the war on Aboriginal and Torres Strait Islander smoking rates in recent times; the war has not yet been won. Evidence suggests that great work has been undertaken in Aboriginal and Torres Strait Islander tobacco control, as illustrated with the significant reductions in Aboriginal and Torres Strait Islander tobacco use.

The reduction in Aboriginal and Torres Strait Islander smoking rates by 10 percent over the last decade (1), as well as the marked increase in the number of Aboriginal and Torres Strait Islander people not taking up smoking (1), demonstrates that efforts to cut smoking rates are working and that further gains are possible.

JENNIFER DOGGETT | February 25, 2015 | CO-PAYMENTS | 2 |

What is the value of a Medicare price signal?

Health Minister Sussan Ley has re-affirmed the Government’s commitment to the GP co-payment, arguing that it is necessary so that people ‘value’ the health care they receive.  In the following piece, the Consumers Health Forum CEO, Adam Stankevicius, questions the Government’s association of price signals with value, given the fact that Medicare has provided Australians [...]

JENNIFER DOGGETT | February 24, 2015 | CHOOSING WISELY | 1 |

Choosing Wisely with The Naked Doctor

In his latest post for Croakey, The Naked Doctor, Justin Coleman, previews the Choosing Wisely campaign, due to launch in Australia in April.  This campaign focuses on cutting down the numbers of unnecessary medical tests and treatment and has been successful in the USA and Canada in reducing non-evidenced based interventions.  While a number of medical colleges have been involved in developing the Choosing Wisely campaign in Australia, this post discusses the Royal Australian College of General Practitioners’ input which focuses on primary health care and will identify five treatments routinely provided in general practice which are not supported by evidence.     

This post is the first in a series that Croakey will be running on Choosing Wisely which, as the Naked Doctor suggests, may make some controversial and confronting recommendations about current medical practices but which has the potential to both increase patient outcomes and save resources.  He writes:    

The Naked Doctor has always prided himself on choosing wisely – except perhaps his clothing choice in inclement weather – so it comes as no surprise that he has embraced Australia’s very own Choosing Wisely campaign, as others might embrace their warm jackets in winter.

This doctor has long recognised the imperative to strip his practice bare of any habit that research demonstrates is probably unhelpful to his patients. He is by no means alone, although, as we shall see, to go naked is to expose oneself to the pricks and barbs of one’s heavily insulated colleagues.

The NPS MedicineWise Choosing Wisely Australia initiative imports the 2012 US Choosing Wisely concept, where medical colleges are invited to highlight tests and treatments that are used widely despite evidence to the contrary. 

Canada’s Choosing Wisely (CW) campaign followed their Southern neighbour’s, and the movement is now spreading to 12 countries, including both England and its former convict outpost down under.


Is the Dietitians Association of Australia in the pocket of Big Food?

Public health lawyer, author and blogger Michele Simon has been investigating conflicts of interest and the Dietitians Association of Australia.  Simon, president of Eat Drink Politics, a corporate watchdog consulting firm in the US, has released an Australian edition of “And Now A Word From Our Sponsors”, detailing close links between the food industry and DAA. [...]


Time as a social determinant of health

Daniel Reeders is a research officer with the What Works and Why project (w3project.org.au) at the Australian Research Centre in Sex, Health and Society. In this post he discusses a recent forum at Vic Health  on ‘Time as a social determinant of health’ and relates it to his personal experience working with a diverse range of communities.

Daniel writes:

On Tuesday, I spent my lunch break at a ‘Talk with your fork’ at VicHealth on ‘time as a social determinant of health’.  I jumped at the invitation to come along and cover it for Croakey, because the core concept – time pressure – had already showed up in my practice in health promotion with different communities.

Whether doing health promotion around HIV and sexual health on ‘African time’* at a freezing church hall in Shepparton, consulting with refugees about when’s the right time after settlement to start talking about sexual health or talking with bicultural community educators about how they support their communities and patch together a living out of casual roles with community organisations. Time was a key factor in all of these discussions. 

In this piece I make a case study of time pressure as a social determinant of cancer screening – but first, let me tell you a bit about the presentations I heard on Tuesday.

MICHELLE HUGHES | February 20, 2015 | CLIMATE CHANGE | |

In brief: Global divestment day

Earlier this month a consortium of health organisations published ‘Unhealthy Investments’ which articulates the strong case for UK health sector (and one could argue all businesses engaged in improving health) in divesting in fossil fuels. In a type of ‘valentine to the planet’, February 13-14 marked global divestment day, celebrating the success of the movement encouraging divestment from fossil [...]


Wonky Health goes out with a bang. And an investigation of Evidence-Based Voting

It is a truth almost universally acknowledged that the state of Australian politics is deeply unsatisfying for those who care about evidence, outcomes and fairness. Perhaps it is time for a novel concept, Evidence-Based Voting? In the final instalment of his crowd-funded Wonky Health column, Dr Tim Senior investigates what difference it might make if [...]

MICHELLE HUGHES | February 18, 2015 | CO-PAYMENTS | |

No payments, copayments and faux payments

Many thanks to Margaret Faux for this précis of an article published in the Internal Medicine Journal on 4 February 2015 No payments, copayments and faux payments: are medical practitioners adequately equipped to manage Medicare claiming and compliance?

Margaret Faux writes:

In an article recently published in the Internal Medicine Journal, my co-authors and I have summarised a selection of available literature concerning medical practitioners’ understanding of Medicare claiming and compliance.

The seed of the paper originated in a systematic review of literature in this area which found that despite much commentary and opinion, little if any empirical research exists on this topic.


For real health reform, turn the spotlight on specialists’ fees

With thanks to The Conversation for allowing us to cross publish this piece by Lesley Russell.

By Lesley Russell, University of Sydney

The impact of specialist fees on government and patient budgets has received little reform attention. This is despite the government’s push for controls in health-care spending and growing evidence of the affordability problems faced by sick Australians.

A high-quality specialist sector is an essential component of an effective health-care system; patients rely on specialist doctors when they are sickest and most vulnerable. And when their treatment inevitably involves expensive treatment options. But specialist care in the community is increasingly hard for many Australians to access, due to geography and cost.


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